Electrolyte And Vitamins Status And Effect Of Supplement On Chinese Patients Pre-and Post-bariatric Surgery-single Center Experience

Background Reliable information on the vitamin status and micronutrient status is still unclear about preoperative and postoperative obesity patients in china,the necessity and effectiveness of the nutrient supplement therapy should have the clinical evidence.Objective This study was compared the pre-and post-nutrition status and nutrition deficiency in LSG?Laparoscopic Sleeve Gastrostomy?and LRYGB?Laparoscopic Roux-en-Y gastric bypass?for 2 years in Chinese patient with obesity,and also survey the compliance of nutrition supplement to find the effectiveness about this supplement plan at 1 year after the surgery.Method In this study,a total of 411 patients were included in the study by comparing weight loss surgery between 2015 and 2016.The surgical procedures were laparoscopic roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy.Measurements of ferritin,iron,total iron binding capacity,hemoglobin,hematocrit,albumin,calcium,magnesium,phosphorus,zinc,folate,and vitamins A\B₁\B₁₂\ C and D were obtained at baseline and 1,3,6,12,24 months after surgery.All patients were given nutrient supplements after surgery and the compliance about the supplement were also recorded by questionnaire on the follow-up.1.According to the postoperative questionnaire,the patients were divided into two groups: postoperative regular supplement and postoperative irregular supplementation.In each large group,the sleeve gastrectomy and gastric bypass group continued to be divided,and the relationship between the surgical styles and the postoperative nutritional status of each group was obtained.2.The postoperative patients can be divided into sleeve gastrectomy and gastric bypass group according to different surgical procedures.In each group,the nutritional status and nutrient supplementation effect of patients with regular nutrient supplementation and irregular supplementation were compared.Results The most serious nutrient deficiency were Vitamin D?98.3 %?,Zinc?29.1%?,Vitamin B1?25.1%?,Vitamin B6?22.5%?and Vitamin C?21.4%?in bariatric candidates.The similar nutrition deficiencies were also found after the surgery in the follow up.From the nutrition supplement follow up,the most effective supplement is folate supplement which had statistical significance from post-3 month to post-12 month and no deficiency at the second year.Most nutrition supplements only make differences in some part of time the follow up.Vitamin Bs deficiencies were more serious in LRYGB than that in LSG(V_B12 31.3% vs 17.6%;V_B628.6% vs 14.3%),while ferritin deficiency was higher in LSG than that in LRYGB.?Ferritin 29.4% vs 4.8%?.Vitamin D,Zn deficiency was still higher in both operation styles.?V_D93.8% in LRYGB,94.1% in LSG;Zn 28.6% in LRYGB,37.5% in LSG?.Conclusion: 1.The nutrition deficiency was common before and after the bariatric surgery.2.The levels of hemoglobin,ferritin and folic acid are affected by the surgical styles;the current nutrient supplementation has effects on folic acid,vitamin B12,ferritin and vitamin D after surgery.3.The general compliance of postoperative patients was poor,and the postoperative follow-up rate was low.4.At present,most of the current nutritional supplement programs in our center cannot be adhered to for a long time.The supplementary methods and supplementary doses need to be further improved.